Sunday, 15 May 2005

It’s not easy for people living on Scotland’s remote islands to find specialist psychological help. Susan Simpson and colleagues at Aberdeen’s Eating Disorders Service investigated the plausibility of using videoconferencing to deliver specialist therapy to six bulimia sufferers who lived in the Shetlands and the remote north east of Scotland. The technology allowed the clients to use a video link at their local clinic to see and talk to a therapist located hundreds of miles away in Aberdeen.

A concern with therapy via videoconferencing is that compared with meeting face to face, it might not be possible to build up the trust and rapport between client and therapist that is known to be so vital to successful therapy. But using a questionnaire-based measure of ‘therapeutic alliance’, Simpson and her team found their six clients had no trouble establishing a successful, rewarding relationship with their therapist via weekly videoconferencing. In fact, three of the clients said they would prefer video therapy to traditional therapy. Two clients had no preference and one said she would prefer face-to-face therapy because it would be more personal and private. By the end of the video therapy, three of the clients had recovered to the extent that they were no longer diagnosed with bulimia.

Interviewed afterwards, the participants said the video therapy was less intimidating than meeting a therapist face-to-face, and gave them a greater sense of control – after all, they could always turn the monitor off! The authors speculated video therapy might, therefore, be particularly beneficial to people with ‘shame-based’ difficulties such as eating disorders.

It wasn’t all positive: several of the local clinics had technical difficulties with the videoconferencing equipment. Also, the lack of soundproof rooms meant the clients sometimes feared other people might overhear their therapy sessions.

“Although the current sample is too small to draw any general conclusions, these initial findings suggest that video therapy leads to improvement in bulimic symptoms for some clients, and may be an acceptable means of treatment delivery for this client group”, the authors said.
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